Characteristics of secondary, primary, and compensated hypogonadism in aging men: Evidence from the European male ageing study

Abdelouahid Tajar, Gianni Forti, Terence W. O'Neill, David M. Lee, Alan J. Silman, Joseph D. Finn, G. Bártfai, Steven Boonen, Felipe F. Casanueva, Aleksander Giwercman, Thang S. Han, Krzysztof Kula, Fernand Labrie, Michael E J Lean, Neil Pendleton, Margus Punab, Dirk Vanderschueren, Ilpo T. Huhtaniemi, Frederick C W Wu, Luisa PetroneGiovanni Corona, Herman Borghs, Jolanta Slowikowska-Hilczer, Renata Walczak-Jedrzejowska, Philip Steer, Stephen Pye, Mary Lage, I. Földesi, I. Fejes, Paul Korrovitz, Ming Jiang

Research output: Contribution to journalArticle

271 Citations (Scopus)

Abstract

Context: The diagnosis of late-onset hypogonadism (LOH) in older men with age-related declines in testosterone (T) is currently not well characterized. Objective: Our objective was to investigate whether different forms of hypogonadism can be distinguished among aging men. Design: The study was a cross-sectional survey on 3369 community-dwelling men aged 40-79 yr in eight European centers. Methods: Four groups of subjects were defined: eugonadal (normal T and normal LH), secondary (low T and low/normal LH), primary (low T and elevated LH), and compensated (normal T and elevated LH) hypogonadism. Relationships between the defined gonadal status with potential risk factors and clinical symptoms were investigated by multilevel regression models. Results: Among the men, 11.8, 2.0, and 9.5% were classified into the secondary, primary, and compensated hypogonadism categories, respectively. Older men were more likely to have primary [relative risk ratio (RRR) = 3.04; P2 or higher was associated with secondary hypogonadism (RRR = 8.74; P <0.001). Comorbidity was associated with both secondary and primary hypogonadism. Sexual symptoms were more prevalent in secondary and primary hypogonadism, whereas physical symptoms were more likely in compensated hypogonadism. Conclusions: Symptomatic elderly men considered to have LOH can be differentiated on the basis of endocrine and clinical features and predisposing risk factors. Secondary hypogonadism is associated with obesity and primary hypogonadism predominately with age. Compensated hypogonadism can be considered a distinct clinical state associated with aging. Classification of LOH into different categories by combining LH with T may improve the diagnosis and management of LOH.

Original languageEnglish
Pages (from-to)1810-1818
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume95
Issue number4
DOIs
Publication statusPublished - Apr 2010

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Hypogonadism
Aging of materials
Testosterone
Delayed Diagnosis
Odds Ratio
Independent Living
Causality
Comorbidity

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

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Characteristics of secondary, primary, and compensated hypogonadism in aging men : Evidence from the European male ageing study. / Tajar, Abdelouahid; Forti, Gianni; O'Neill, Terence W.; Lee, David M.; Silman, Alan J.; Finn, Joseph D.; Bártfai, G.; Boonen, Steven; Casanueva, Felipe F.; Giwercman, Aleksander; Han, Thang S.; Kula, Krzysztof; Labrie, Fernand; Lean, Michael E J; Pendleton, Neil; Punab, Margus; Vanderschueren, Dirk; Huhtaniemi, Ilpo T.; Wu, Frederick C W; Petrone, Luisa; Corona, Giovanni; Borghs, Herman; Slowikowska-Hilczer, Jolanta; Walczak-Jedrzejowska, Renata; Steer, Philip; Pye, Stephen; Lage, Mary; Földesi, I.; Fejes, I.; Korrovitz, Paul; Jiang, Ming.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 95, No. 4, 04.2010, p. 1810-1818.

Research output: Contribution to journalArticle

Tajar, A, Forti, G, O'Neill, TW, Lee, DM, Silman, AJ, Finn, JD, Bártfai, G, Boonen, S, Casanueva, FF, Giwercman, A, Han, TS, Kula, K, Labrie, F, Lean, MEJ, Pendleton, N, Punab, M, Vanderschueren, D, Huhtaniemi, IT, Wu, FCW, Petrone, L, Corona, G, Borghs, H, Slowikowska-Hilczer, J, Walczak-Jedrzejowska, R, Steer, P, Pye, S, Lage, M, Földesi, I, Fejes, I, Korrovitz, P & Jiang, M 2010, 'Characteristics of secondary, primary, and compensated hypogonadism in aging men: Evidence from the European male ageing study', Journal of Clinical Endocrinology and Metabolism, vol. 95, no. 4, pp. 1810-1818. https://doi.org/10.1210/jc.2009-1796
Tajar, Abdelouahid ; Forti, Gianni ; O'Neill, Terence W. ; Lee, David M. ; Silman, Alan J. ; Finn, Joseph D. ; Bártfai, G. ; Boonen, Steven ; Casanueva, Felipe F. ; Giwercman, Aleksander ; Han, Thang S. ; Kula, Krzysztof ; Labrie, Fernand ; Lean, Michael E J ; Pendleton, Neil ; Punab, Margus ; Vanderschueren, Dirk ; Huhtaniemi, Ilpo T. ; Wu, Frederick C W ; Petrone, Luisa ; Corona, Giovanni ; Borghs, Herman ; Slowikowska-Hilczer, Jolanta ; Walczak-Jedrzejowska, Renata ; Steer, Philip ; Pye, Stephen ; Lage, Mary ; Földesi, I. ; Fejes, I. ; Korrovitz, Paul ; Jiang, Ming. / Characteristics of secondary, primary, and compensated hypogonadism in aging men : Evidence from the European male ageing study. In: Journal of Clinical Endocrinology and Metabolism. 2010 ; Vol. 95, No. 4. pp. 1810-1818.
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abstract = "Context: The diagnosis of late-onset hypogonadism (LOH) in older men with age-related declines in testosterone (T) is currently not well characterized. Objective: Our objective was to investigate whether different forms of hypogonadism can be distinguished among aging men. Design: The study was a cross-sectional survey on 3369 community-dwelling men aged 40-79 yr in eight European centers. Methods: Four groups of subjects were defined: eugonadal (normal T and normal LH), secondary (low T and low/normal LH), primary (low T and elevated LH), and compensated (normal T and elevated LH) hypogonadism. Relationships between the defined gonadal status with potential risk factors and clinical symptoms were investigated by multilevel regression models. Results: Among the men, 11.8, 2.0, and 9.5{\%} were classified into the secondary, primary, and compensated hypogonadism categories, respectively. Older men were more likely to have primary [relative risk ratio (RRR) = 3.04; P2 or higher was associated with secondary hypogonadism (RRR = 8.74; P <0.001). Comorbidity was associated with both secondary and primary hypogonadism. Sexual symptoms were more prevalent in secondary and primary hypogonadism, whereas physical symptoms were more likely in compensated hypogonadism. Conclusions: Symptomatic elderly men considered to have LOH can be differentiated on the basis of endocrine and clinical features and predisposing risk factors. Secondary hypogonadism is associated with obesity and primary hypogonadism predominately with age. Compensated hypogonadism can be considered a distinct clinical state associated with aging. Classification of LOH into different categories by combining LH with T may improve the diagnosis and management of LOH.",
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T1 - Characteristics of secondary, primary, and compensated hypogonadism in aging men

T2 - Evidence from the European male ageing study

AU - Tajar, Abdelouahid

AU - Forti, Gianni

AU - O'Neill, Terence W.

AU - Lee, David M.

AU - Silman, Alan J.

AU - Finn, Joseph D.

AU - Bártfai, G.

AU - Boonen, Steven

AU - Casanueva, Felipe F.

AU - Giwercman, Aleksander

AU - Han, Thang S.

AU - Kula, Krzysztof

AU - Labrie, Fernand

AU - Lean, Michael E J

AU - Pendleton, Neil

AU - Punab, Margus

AU - Vanderschueren, Dirk

AU - Huhtaniemi, Ilpo T.

AU - Wu, Frederick C W

AU - Petrone, Luisa

AU - Corona, Giovanni

AU - Borghs, Herman

AU - Slowikowska-Hilczer, Jolanta

AU - Walczak-Jedrzejowska, Renata

AU - Steer, Philip

AU - Pye, Stephen

AU - Lage, Mary

AU - Földesi, I.

AU - Fejes, I.

AU - Korrovitz, Paul

AU - Jiang, Ming

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N2 - Context: The diagnosis of late-onset hypogonadism (LOH) in older men with age-related declines in testosterone (T) is currently not well characterized. Objective: Our objective was to investigate whether different forms of hypogonadism can be distinguished among aging men. Design: The study was a cross-sectional survey on 3369 community-dwelling men aged 40-79 yr in eight European centers. Methods: Four groups of subjects were defined: eugonadal (normal T and normal LH), secondary (low T and low/normal LH), primary (low T and elevated LH), and compensated (normal T and elevated LH) hypogonadism. Relationships between the defined gonadal status with potential risk factors and clinical symptoms were investigated by multilevel regression models. Results: Among the men, 11.8, 2.0, and 9.5% were classified into the secondary, primary, and compensated hypogonadism categories, respectively. Older men were more likely to have primary [relative risk ratio (RRR) = 3.04; P2 or higher was associated with secondary hypogonadism (RRR = 8.74; P <0.001). Comorbidity was associated with both secondary and primary hypogonadism. Sexual symptoms were more prevalent in secondary and primary hypogonadism, whereas physical symptoms were more likely in compensated hypogonadism. Conclusions: Symptomatic elderly men considered to have LOH can be differentiated on the basis of endocrine and clinical features and predisposing risk factors. Secondary hypogonadism is associated with obesity and primary hypogonadism predominately with age. Compensated hypogonadism can be considered a distinct clinical state associated with aging. Classification of LOH into different categories by combining LH with T may improve the diagnosis and management of LOH.

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